Background: Unsuccessful treatment outcomes among patients with drug resistant tuberculosis (DR-TB) are due to high rates of adverse events (AEs). However, information related to AEs is not systematically collected and managed under programmatic setting. The present study assessed the a) incidence and pattern of adverse events in first three months of DR-TB treatment initiation; b) treatment seeking behaviour for AE management; and c) explore the challenges in seeking treatment and reporting AEs. Methods: This mixed methods study included all patients diagnosed and initiated on treatment under RNTCP during July-September 2018 at Ahmedabad DR-TB centre. The patients were interviewed telephonically and assessed for all AEs experienced by them. In-depth interviews and key-informant interviews were conducted among patients, DOTS supervisors and programme staffs (treatment supervisors, medical officer and district program manager). Results: A total 207 AEs were reported by the 74 DR-TB patients. All patients experienced at least one AE during initial treatment period. Incidence rate of AEs (experienced) was 3.11 (1st month-4.6, 2nd month-2.7, 3rd month-2.02) per 100 person days. Of the 207 AEs, gastro-intestinal (59, 28.3%), ophthalmic (32, 15.4%) and otolaryngology (25, 11.9%) system related AEs were commonly experienced. Treatment was not sought in two-fifths of the AEs. Themes and subthemes related to challenges in treatment seeking or reporting of AEs were 1) Patient related-Misconceptions, accessibility and affordability of management, lack of counselling support, stigma and discrimination, and past treatment experience; 2) Health system related-lack of guideline and training for AE management, and poor coordination between hospital and tuberculosis centre. Conclusion: The incidence of AEs was high among patients with DR-TB in the first three months of treatment and treatment seeking/reporting was low. Adequate health education and counselling of the patient and orientation of the health systems are the need of the hour. An efficient real-time reporting and management of AE can be developed and tested for effective DR-TB control. Background Tuberculosis (TB) is the leading infectious cause of death and still continues to be a major public health problem. The emerging issue of Drug-resistant Tuberculosis (DR-TB) due to inappropriate

No abstract

Abstract:Introduction: Growing evidence suggests that occupational exposure to carbon black may be a risk factor to the cardiovascular and respiratory systems. Objectives: To spotlight cardiopulmonary changes among workers exposed to carbon black, to find out different risk factors which may increase the health hazards and to determine the most effective intervention strategy to limit health hazards of carbon black exposure. Materials and Methods: A cross sectional study was done in carbon black factory in Borg Elarab , Alexandria. The studied group was subjected to a questionnaire including detailed occupational, present and past histories. General examination was done, blood pressure was measured in erect and supine positions and average was taken. Mean arterial blood pressure was calculated. Investigations were done including: CBC, pulmonary function testing (FVC and FEV1) and Plain chest x-ray. Results: the current study detected that DBP was higher among highly exposed group ( 80.7±9) compared to moderately exposed (77.6±9) and unexposed (76.5±8) (statistically significant ). Mean arterial blood pressure was higher among highly exposed (95±8.4) and moderately exposed (92.3±9) group compared to unexposed group (84.5±8.6) and also highly exposed departments compared to moderately exposed with significant difference . As regard FEV1 was higher among unexposed group (3.8±0.7) compared to moderately exposed (3.5±0.8) and highly exposed (3.4±0.9) with statistically significant difference (p < 0.05). Also FVC was higher among unexposed group (4.8±0.7) compared to moderately exposed group (4.6±0.9) which was slightly higher than highly exposed group (4.3±0.8) with statistically significant difference. Both % of FEV1/FVC and